Patients & Carers meeting May 2017

Dr Susana Marinho is the Consultant Allergist at the North West Lung Centre, University Hospital of South Manchester and was the first full time consultant of this type in the NHS when appointed in 2009.

Susana was asked by National Aspergillosis Centre director Prof David Denning to comment on the role of salicylate allergy in the treatment of respiratory disease & sinusitis as it can worsen several asthma & other symptoms when taken in the form of aspirin and is often treated partly by putting the patient on a diet consisting of foods low in salicylate.

It turns out that aspirin can worsen asthma symtoms but this is not usually caused by an allergic reaction and that has implications for which alternatives to aspirin (Non-steroidal anti-inflammatory drugs (NSAID)) could be used to help treat respiratory disease. Consequently if a respiratory (or sinusitis) patent reports an allergic response to aspirin referral to an allergist is important to help work out whether it is a true allergy, a pseudo-allergy and which groups of NSAIDs are likely to be acceptable instead.

The levels of salicylate in food and the amount absorbed are unlikely to reach levels that are going to contribute to a sensitivity reaction and there is no evidence that a low salicylate diet has any clinical advantage, so Dr Marinho discounts the usefulness of such a diet except in very rare circumstances.

Resources mentioned:

• NHS Choices: Allergy Services UHSM
• Salicylate sensitivity
• UHSM Merger with other GT Manchester Hospitals